A prospective study of outcomes, healthcare resource utilization, and costs associated with postoperative nosocomial infections

Loreen A. Herwaldt, Joseph J. Cullen, David Scholz, Pamela French, M. Bridget Zimmerman, Michael A. Pfaller, Richard P. Wenzel, Trish M. Perl

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

OBJECTIVE. We evaluated 4 important outcomes associated with postoperative nosocomial infection: costs, mortality, excess length of stay, and utilization of healthcare resources. DESIGN. The outcomes for patients who underwent general, cardiothoracic, and neurosurgical operations were recorded during a previous clinical trial. Multivariable analyses including significant covariates were conducted to determine whether nosocomial infection significantly affected the outcomes. SETTING. A large tertiary care medical center and an affiliated Veterans Affairs Medical Center. PATIENTS. A total of 3,864 surgical patients. RESULTS. The overall nosocomial infection rate was 11.3%. Important covariates included age, Karnofsky score, McCabe and Jackson classification of the severity of underlying disease, National Nosocomial Infection Surveillance system risk index, and number of comorbidities. After accounting for covariates, nosocomial infection was associated with increased postoperative length of stay, increased costs, increased hospital readmission rate, and increased use of antimicrobial agents in the outpatient setting. Nosocomial infection was not associated independently with a significantly increased risk of death in this surgical population. CONCLUSION. Postoperative nosocomial infection was associated with increased costs of care and with increased utilization of medical resources. To accurately assess the effects of nosocomial infections, one must take into account important covariates. Surgeons seeking to decrease the cost of care and resource utilization must identify ways to decrease the rate of postoperative nosocomial infection.

Original languageEnglish (US)
Pages (from-to)1291-1298
Number of pages8
JournalInfection Control and Hospital Epidemiology
Volume27
Issue number12
DOIs
StatePublished - Dec 1 2006

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Cross Infection
Prospective Studies
Delivery of Health Care
Costs and Cost Analysis
Length of Stay
Patient Readmission
Veterans
Anti-Infective Agents
Tertiary Care Centers
Comorbidity
Outpatients
Clinical Trials
Mortality

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Cite this

A prospective study of outcomes, healthcare resource utilization, and costs associated with postoperative nosocomial infections. / Herwaldt, Loreen A.; Cullen, Joseph J.; Scholz, David; French, Pamela; Zimmerman, M. Bridget; Pfaller, Michael A.; Wenzel, Richard P.; Perl, Trish M.

In: Infection Control and Hospital Epidemiology, Vol. 27, No. 12, 01.12.2006, p. 1291-1298.

Research output: Contribution to journalArticle

Herwaldt, Loreen A. ; Cullen, Joseph J. ; Scholz, David ; French, Pamela ; Zimmerman, M. Bridget ; Pfaller, Michael A. ; Wenzel, Richard P. ; Perl, Trish M. / A prospective study of outcomes, healthcare resource utilization, and costs associated with postoperative nosocomial infections. In: Infection Control and Hospital Epidemiology. 2006 ; Vol. 27, No. 12. pp. 1291-1298.
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